European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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We often encounter elementary school-aged children with fresh lumbar spondylolysis and non-union of bone. They may have factors that impede healing, and treatment outcomes need improvement. The purpose of this study was to investigate elementary school-aged patients with fresh lumbar spondylolysis and to identify characteristics that can aid in prompt diagnosis and proper therapy. ⋯ L5 lumbar spondylolysis, L5 SBO, and contralateral pars defect were important diagnostic factors in elementary school-aged patients. Identification of these characteristics will aid in prompt diagnosis and proper therapy.
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Spinal DSA is the "gold standard" technique to identify the spinal vascular diseases with venous hypertensive myelopathy (VHM). However, sometimes spinal DSA can find nothing in patients with confirmed spinal vascular anomalies. Many of the reasons are avoidable technical factors. Nevertheless, there are also some non-technical factors. The objective of this study was to identify the non-technical factors. ⋯ In order to avoid the missed findings of spinal vascular diseases with VHM, the technical factors should be reduced by performing a rigorous comprehensive angiography. To reduce the non-technical factors, the angiography of the internal iliac artery, the carotid artery systems and spinal draining veins should be performed in some special cases if the routine spinal angiography can find nothing.
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The Gait Deviation Index (GDI) is a composite measure of gait abnormality derived from lower-limb joint range-of-motion which is increasingly being reported for clinical gait analysis among neurologic and orthopedic patients. A GDI score of 100 is representative of healthy individuals and decreasing scores represent a greater abnormality. Preliminary data is needed to help assess the utility of GDI as a measure of compromised gait among spine patients and to provide reference values for commonly treated pathologies. ⋯ Composite metrics like GDI provide a tempting means to summarize nuanced and complex gait characteristics into a single, comparable value among cohorts. The results of this study provide preliminary GDI scores for common degenerative spine pathologies. These slides can be retrieved under Electronic Supplementary Material.
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To describe a classification of fractures of the coccyx, according to their mechanism. ⋯ For the first time, a classification of fractures of the coccyx is presented. Each type exhibits specific features. This should help the clinician in the management of these patients. These slides can be retrieved under Electronic Supplementary Material.
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Psychological and social factors are involved in the disability and chronicity of pain. Our study aim was to investigate whether social defeat stress (SDS) as a psychophysical stress affected mechanical withdrawal thresholds in the lumbar disk herniation (LDH) rat model. Changes in microglia and astrocytes, which play important roles in neuropathic pain states, were also investigated. ⋯ SDS prolongs mechanical allodynia induced by NP. Changes of GFAP expression in the VLPAG were associated with mechanical allodynia of the NP + SDS group during the late phase. These results suggest that psychological chronic stress might delay recovery from mechanical allodynia induced by the LDH model.